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Environmental Health Department <br />10. <br />11. <br />OR <br />12. <br />Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />13. <br />**lmportant** <br />Owner14.Completed by: <br />Title <br />Paper Hand Towels <br />Soap dispenser <br />Cutting Board <br />BleachPropane Stove <br />Propane Tank <br />Piro ExUnpulsher <br />Ice Cooler <br />B <br />I <br />Soap and Water <br />EHD 16-02 <br />06/19/19 <br />Names of responsible persons to be present In booth during all hours of operation: <br />Janeen and Jeff Taplin <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />Exira <br />Water <br />6 Gal Hand waah <br />Wastewater Container <br />6-20 Gal, <br />Hand wash Waler <br />Garbage <br />Can <br /> Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />^One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />XI Paper towels and pump-style soap container. <br />All food vendor booths are subject to Inspection. Please make a copy of this application In <br />preparation for this event. A copy of this checklist must be In the booth at all hours of <br />preparation and operation. Return original to festival coordinator three weeks prior to <br />this event. <br />Sanitizer bucket­ <br />bleach & water for <br />storing wiping cloths <br />Sier no w/ChaNing <br />Dish <br />\ <br />Bleach and Water <br />Signature <br />8/7/19 <br />Date <br />~z <br />Rinse Water <br />Extra Ico Bags t Food Coniainers must be ■ <br />stored 6 Inches off of the ground! M <br />V SANJOAOUIN <br />•' ------COUNTY------ <br />Greacnesi Ofow.- here. <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45OF (if food is used the following day, maintain below 41 °F temperature): <br />XJ Ice chests Refrigerator <br /> Refrigerated truck Ice bath and tubs <br /> Other (specify) <br />| Health Permit p <br />I am providing the following Items within my booth for the sanitary cleaning of food preparation utensil <br /> Three compartment sink. <br />Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />solution (one tablespoon of bleach per gallon of water). <br /> Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420) F 209 464-0138 | www.sjgov.org/ehd <br />Page 8 or 11 TEMP EVENT APP <br />,• .. ..<=-•